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General NPI Number Information
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NPI Number | 1104504919
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Entity Type | Organization
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Legal Business Name | ASTACIO PSYCHOLOGICAL CLINIC
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | LOCAL 5 CARR 402 KM 2.9 VALLEY HILLS PROFESSIONAL CENTER
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-400-5484
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Fax |
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Provider Business Mailing Address
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Address Line | URB VALLE REAL CALLE ISABEL 25002
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-673-0685
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARACELYS ASTACIO RUIZ
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Credential | DRA
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Telephone | 787-673-0685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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